I am not sleeping at night. I can fall asleep, but I cannot stay asleep for the night. I usually wake up 3- 4 times per night and then will finally get up. Not sure if this is stress-related or not. I went to my doctor and she just prescribed medication. I have tried the medication but I will still wake up sometimes during the night. Plus I really don’t want to take meds and I want to find out if there is anything more to it. Thank you.

Dr. Norquist responds:

It must be very frustrating to wake up 3 – 4 times a night on a regular basis. I’m sorry you are having to cope with this in your life currently. A restful, restorative night’s sleep can be a prized commodity. With insomnia, I often use the analogy of a racing motor that doesn’t return to a slow idle when at a stoplight. Instead it idles too high or worse yet, stays racing. Our body/mind cannot go at will from 90 mph to a slow idle. For it to function optimally we need to respect our body’s need for a balance between on-time (when we are alert and active) and downtime (for rest and relaxation). With too much on-time, our bodies pump an excess of adrenaline into our systems, our minds race and we have difficulty dropping into a restful, restorative state of sleep.

There is an art to knowing how to calm your nervous system, and move into a state of ease and relaxation. Mothers set up a calming routine to help their children to move into a readiness for sleep. They do this by establishing a regular sleep-wake cycle, reducing activity and stimulation levels for an hour or two before bedtime, establishing bath and story-time rituals, and providing a sense of comfort and safety.

You would be wise to mother yourself by consciously developing your own bedtime routines. Exercise is helpful, but make sure that it is before dinner and not within a few hours of your preferred bedtime. Try not to eat too late, or too heavily. Avoid heavy alcohol consumption and caffeine or nicotine. Develop a nighttime routine that helps you to relax your muscles. This could include stretching, yoga postures that enhance relaxation, deep abdominal breathing, and/or a guided imagery relaxation CD. There are many helpful herbal and homeopathic remedies for promoting more restful sleep. Nature’s Pharmacy has a product called Relaxing Sleep Tonic that is helpful. Calms Forte, by Hyland, is a homeopathic remedy that helps to calm the mind. Check with your local health food store and your MD for advice in this regard. Also, try to accept the fact that you will sometimes have difficulty sleeping. The less upsetting this is to you, the easier it will be for you to fall asleep.

I don’t know what underlying factors may be causing your insomnia. Sometimes waking up in the middle of the night and chronic insomnia in general may be a sign of an underlying depression or an anxiety disorder. If you consciously commit to trying some of these ideas and your insomnia doesn’t improve, then it would be wise to seek professional help. I hope these suggestions will prove to be helpful to you.

(Dr. Sallie Norquist is a licensed psychologist (NJ #2371) in private practice and is director of Chaitanya Counseling Services, a center for upliftment and enlivenment, in Hoboken.) Dr. Norquist and the staff of Chaitanya invite you to write them at Chaitanya Counseling Services, 51 Newark St., Suite 202, Hoboken, NJ 07030 or www.chaitanya.com or by e-mail at drnorquist@chaitanya.com, or by fax at (201) 656-4700. Questions can address various topics, including relationships, life’s stresses, difficulties, mysteries and dilemmas, as well as questions related to managing stress or alternative ways of understanding health-related concerns. 2012 Chaitanya Counseling Services